Document Detail


Dynamic and static magnetic resonance angiography of the supra-aortic vessels at 3.0 T: intraindividual comparison of gadobutrol, gadobenate dimeglumine, and gadoterate meglumine at equimolar dose.
MedLine Citation:
PMID:  23211552     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The purpose of this study was the intraindividual comparison of a 1.0 M and two 0.5 M gadolinium-based contrast agents (GBCA) using equimolar dosing in dynamic and static magnetic resonance angiography (MRA) of the supra-aortic vessels.
MATERIALS AND METHODS: In this institutional review board-approved study, a total of 20 healthy volunteers (mean ± SD age, 29 ± 6 years) underwent 3 consecutive supra-aortic MRA examinations on a 3.0 T magnetic resonance system. The order of GBCA (Gadobutrol, Gadobenate dimeglumine, and Gadoterate meglumine) was randomized with a minimum interval of 48 hours between the examinations. Before each examination and 45 minutes after each examination, circulatory parameters were recorded. Total GBCA dose per MRA examination was 0.1 mmol/kg with a 0.03 mmol/kg and 0.07 mmol/kg split for dynamic and static MRA, respectively, injected at a rate of 2 mL/s. Two blinded readers qualitatively assessed static MRA data sets independently using pairwise rankings (superior, inferior, and equal). In addition, quantitative analysis was performed with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) evaluation as well as vessel sharpness analysis of static MRA using an in-house-developed semiautomated tool. Dynamic MRA was evaluated for maximal SNR. Statistical analysis was performed using the Cohen κ, the Wilcoxon rank sum tests, and mixed effects models.
RESULTS: No significant differences of hemodynamic parameters were observed. In static MRA, Gadobutrol was rated superior to Gadoterate meglumine (P < 0.05) and equal to Gadobenate dimeglumine (P = 0.06) with good to excellent reader agreement (κ, 0.66-0.83). In static MRA, SNR was significantly higher using 1.0 M Gadobutrol as compared with either 0.5 M agent (P < 0.05 and P < 0.05) and CNR was significantly higher as compared with Gadoterate meglumine (P < 0.05), whereas CNR values of Gadobutrol data sets were not significantly different as compared with Gadobenate dimeglumine (P = 0.13). Differences in CNR between Gadobenate dimeglumine and Gadoterate meglumine were not significant (P = 0.78). Differences in vessel sharpness between the different GBCAs were also not significant (P > 0.05). Maximal SNR in dynamic MRA using Gadobutrol was significantly higher than both comparators at the level of the proximal and distal internal carotid artery (P < 0.05 and P < 0.05; P < 0.05 and P < 0.05).
CONCLUSIONS: At equimolar doses, 1.0 M Gadobutrol demonstrates higher SNR/CNR than do Gadobenate dimeglumine and Gadoterate meglumine, with superior image quality as compared with Gadoterate meglumine for dynamic and static carotid MRA. Despite the shortened bolus with Gadobutrol, no blurring of vessel edges was observed.
Authors:
Jens Harald Kramer; Elisabeth Arnoldi; Christopher J François; Andrew L Wentland; Konstantin Nikolaou; Bernd J Wintersperger; Thomas M Grist
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Investigative radiology     Volume:  48     ISSN:  1536-0210     ISO Abbreviation:  Invest Radiol     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-01-31     Completed Date:  2013-07-11     Revised Date:  2013-11-14    
Medline Journal Info:
Nlm Unique ID:  0045377     Medline TA:  Invest Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  121-8     Citation Subset:  IM    
Affiliation:
Institute for Clinical Radiology, Ludwig Maximilians University Hospital Munich, Munich, Germany. harald.kramer@med.lmu.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aorta / anatomy & histology*
Contrast Media / administration & dosage
Female
Humans
Magnetic Resonance Angiography / methods*
Magnetic Resonance Imaging, Cine / methods*
Male
Meglumine / administration & dosage,  analogs & derivatives*,  diagnostic use
Organometallic Compounds / administration & dosage,  diagnostic use*
Reproducibility of Results
Sensitivity and Specificity
Grant Support
ID/Acronym/Agency:
T32 GM008692/GM/NIGMS NIH HHS
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Organometallic Compounds; 0/gadoterate meglumine; 138071-82-6/gadobutrol; 15G12L5X8K/gadobenic acid; 6284-40-8/Meglumine
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